Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.

General Job Description

Responsible for the oversight of all functions within the Coding Operation departments, including but not limited to providing support at the division level for daily departmental operations, reimbursement opportunities, and various programs. Serve as a member of the team; subscribe to the vision, values and expectations of the Duke University Health System.

Job Duties

Duties

% of Time

1. Oversee Quality/Focused Audits for all PRMO Coding teams- PB and HB

20%

1. Act as contact and coordinator for organization auditing needs

5%

1. Identify areas for improvement and recommend solutions where education is needed for accurate coding and billing for both Hospital and Professional areas.

5%

1. Provide direction for department; Ensure TAT are met, QC of auditor QA, Ensure departmental integration, develop operational policies, procedures, standards and expectations, provide clear opportunities to meet or exceed objectives

20%

1. Assist with policy and procedure maintenance for coding and auditing functions

5%

1. Read and interpret LCD, NCD and other payer regulations and guidelines as related to coverage of services

10%

1. Interviewing, hiring, training employees, planning, assigning, and directing workflows, employee performance evaluation, proactively manage production and quality controls, resolving problems.

10%

1. Collaborate with other managers to ensure consistent implementation of coding policies, procedures and practice; maintain strong communications with director and peer managers

20%

1. Any/All other duties assigned by director

5%

Knowledge, Skills and Abilities

Extensive knowledge of ICD-10-CM, PCS and CPT coding principal and guidelines. Extensive knowledge of hospital/technical and professional services reimbursement systems (DRGs, APCs, RBRVUs). Extensive knowledge of Federal, State and payer specific regulations and policies pertaining to documentation, coding, billing for technical and professional services, strong managerial leadership, and interpersonal skills. Excellent written and oral communication skills, excellent analytical skills.

Education Requirements / Preferences

BS Health Information Management, Health Informatics, Health Administration, Finance or related field. Master's degree in Business Administration or Health Administration is preferred

Experience Requirements / Preferences

Six years of experience in the healthcare industry is required, two of the six years are supervising or coordinating coding activities.

Licensure / Certification Requirements

Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT). Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) is a bonus.

Financial Responsibilities

X Develop budget recommendations

X Prepare budget requests and written narratives

X Review expenses against budget

Supervisory

Responsibilities

Duties

% of Time

1. Compliance Specialist

6

Working Conditions

Mark all that apply

X

Must be able to work under time pressures in a busy virtual office environment

Must be present on site for 8 hour shifts during standard business hours

X

Must participate in group activities requiring interpersonal skills and cooperation

X

Must work as later person when scheduled or according to business need

X

Must be able to react quickly and immediately respond to emergencies

Must travel between locations on a needed basis

X

Must be able to handle multiple assignments, conflicting demands and priorities

X

Must maintain attention to detail over extended period of time

X

Must be continually aware of variations in changing situations

Must be able to move throughout office environment throughout the day

Must be able to lift XX lbs.

Must be able to push/pull XX lbs.

Must be able to carry XX lbs.

Must be able to reach for objects by extending arms